Sporda Ani Ölümler ve Apolipoprotein (APO)-B100 İlişkisi

Sibel Tetik Dündar

doi:10.37609/akya.3496

Yazarlar

Sibel Tetik Dündar

https://orcid.org/0000-0001-6813-0969

DOI: https://doi.org/10.37609/akya.3496.c7984

Özet

Binlerce genç fiziksel aktivite sırasında aniden ölmektedir. Sporla ilişkili ani kardiyak ölümün (SCD) yılda milyonda 3-5 vakaya denk geldiği ve vakaların %6'sının genç yarışmacı sporcularda, çoğunluğunun erkeklerde (%95) meydana geldiği tahmin edilmektedir. Çoğu durumda, sporcunun farkında olmayabileceği altta yatan bir kalp hastalığı olabilmektedir. Kalp durması, egzersiz sırasında veya hemen sonrasında, genellikle öncü semptomlar olmadan gerçekleşir. Bilim camiasında kalan soru, Sporla ilişkili ani kardiyak ölümün sporlarda meydana gelmesini önceden tahmin edip edemeyeceğimiz ve kalp durmasının ani ölüme ilerlemesini önemli ölçüde azaltıp azaltamayacağımızdır.
Kardiyovasküler hastalık (KVD), dünya çapında önde gelen bir ölüm nedenidir. Statinler düşük yoğunluklu lipoprotein kolesterolü (LDL-K) düşürerek kardiyovasküler (KV) sonuçları belirgin şekilde iyileştirse de KV olayları hastaların önemli bir kısmında devam eder. Dünya çapında, bu tür hastalarda (yani, KV riski kalanlarda) KV olaylarını ortadan kaldırma çabaları, trigliserit açısından zengin lipoprotein kolesterol veya lipoprotein(a) (Lp(a)) gibi LDL dışı KV'leri düzenleyerek yapılmıştır. Karaciğerde sentezlenen LDL benzeri bir partikül olan Lp(a), KV olayları olan hastalarda optimum LDL-K yönetimine rağmen yükseldiği bilinmektedir. Lp(a), apoA'ya kovalent olarak bağlı apolipoprotein (apo) B100'den oluşur. Lp(a) karakteristik olarak hem apoB'den hem de apoA'dan aterojeniteyi ve apoA'dan protrombojenik ve proinflamatuar özellikleri miras alır.
Plazma lipoproteinleri oluşturan apoproteinler kolesterol ester ile trigliseridlerin çözülmesine yardımcı olur, bu lipidlerin bazı önemli enzimlerle reaksiyona girmelerini düzenler ve de hücre yüzeyindeki reseptörlere bağlanıdar. Çeşitli apolipoproteinlerden klinik açıdan en önemli ikisi apolipoprotein A ve apolipoprotein B (apoB) dir. Koroner risk yönünden apoB özellikle LDL kökenli riski yansıtır.

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